GRANVILLE — A more recent problem with late reimbursement payments has involved a limit placed by the state on the number of prescriptions that Medicaid patients can have filled.

Under a budget-cutting measure enacted by the Legislature last year, Medicaid patients are generally limited to four prescriptions a month, although there are procedures for exceeding that in some cases.

That was one of the factors mentioned by independent pharmacy owner Marlon Weekley as figuring into his recent decision to close 43-year-old Granville Drug, and the issue has garnered a great deal of attention from the Illinois Pharmacists Association.

“This misguided policy was put into effect last summer as part of the Save Medicaid Access and Resources Together Act,” Mickie Brunner, a Chicago-area pharmacist who is president of the organization, wrote in an op-ed column in the (Springfield) State Journal-Register in March.

“The acronym for the legislation is the SMART Act, but there’s nothing smart about limiting patients to four prescriptions regardless of their health condition.”

The consequences for patients can be serious because people with already limited resources can wind up foregoing steps to treat or manage their health problems.

“It puts recipients in the position of deciding ‘Which disease do I treat this month?’” said Garth Reynolds, executive director of the 2,000-member association.

Besides the possible effect on the health of individuals, the measure could ultimately cost more in the long run by resulting in more people seeking care in an emergency room or hospitalization for conditions that could be managed with medication.

“There are other states that have tried this and failed,” Reynolds said.